Appealing Medicaid Denial and Involuntary Discharge Because of Immigration Status

HNWAppealing the Denial of Medicaid

medicaid-denialRecently, we were advised that a client of ours was a lawful permanent resident, and had resided in the US continuously since 1985.  The client did not tell us he arrived on a visitor visa in 1988, and did not have legal status until March 2018.

We received a copy of the green card on October 2, 2020.  We found out his daughter had sponsored him.  I do not know if she filed an affidavit of support.

Because our client has not been a lawful permanent resident for 5 years, his application for MLTSS was denied.  We advised the client orally that if she wanted to request a fair hearing, the deadline to submit her appeal was quickly approaching.

Analysis of a Successful Fair Hearing Appeal

Under these facts, I do not believe a fair hearing will be successful.  We have previously obtained MLTSS for a lawful permanent resident who had lawful status for the 5 years required by federal law and New Jersey statute(s) and regulation.  Federal law (the Personal Responsibility and Work Opportunity Reconciliation Act of 1996) requires a resident alien to have lawful permanent resident status for five (5) years before receiving anything but emergency Medicaid.  New Jersey regulation and statute appears to be against this client.

A quick review of the definitions section in N.J.S.A. 30:4D-1 defines “lawful alien” in subsection “q”.  He does not clearly fall within the definition.  N.J.A.C. 10:71-3.2 refines the definition of “lawful alien”.  It appears to exclude him from the class of individuals entitled to MLTSS because he was not a lawful alien before he received his green card.

We declined taking this case to a fair hearing.  The client was not forthcoming about his immigration status when we filed the Medicaid application.  With the information now available, I think we will lose on those merits.

To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at  Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.

By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Appeal of Medicaid Denial Attorney

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